The Short-term Effect Of Local Analgesia On Laparoscopic Surgery Of Patients With Colorectal Cancer

Objective: Most patients experienced acute pain after operation,and the postoperative pain was usually moderate,severe or worse.Postoperative analgesia can not only affect the patients’ sleep and mood,but also aggravate the stress response of the body and affect the postoperative recovery of patients.Clinically,the analgesic pump is the most common mode of postoperative analgesia,however,with the recognition of the analgesic pump adverse reaction(such as nausea,emesis,urine retention,etc.),we constantly explore the postoperative analgesia mode of the patient.If we can reduce systemic drug use and increase the application of local anesthetics,we can not only reduce the adverse reaction of analgesic pump,obtain better analgesic effect,but also promote postoperative recovery of patients.Therefore,the continuous infiltration anesthesia block has become a hot spot for clinicians.This paper aims to explore the effects of local analgesia on postoperative analgesic effect,laboratory index and postoperative recovery of colorectal cancer patients.Methods: By adopting the method of prospective randomized controlled clinical study design,in February 2017 to February 2018 period,the affiliated hospital of Qingdao university gastrointestinal surgical treatment of colorectal cancer patients,divided into local analgesia,basic analgesia group.Local analgesia group using intraoperative side holes into multiple catheter between the subcutaneous tissue and the fascia,end of the catheter placed in the lateral incision,1:1 diluted ropivacaine(75 mg/10 ml)was injected every 12 hours after operation,and if the pain was heavier,it could be append 1 time and used for 3 days.The basic analgesic group directly sutured the wound and did not make the incision local infiltration block.On the day of surgery,the injection of flurbilofenac injection(50 mg/5ml)was administered every 12 hours on the first day after the operation,and was used for 3 days.The pain score,fatigue index and clinical recovery of the two groups were observed and compared.Respectively in preoperative and postoperative day 1,3 and 5 days early in the morning,extraction of two groups of patients with peripheral venous blood samples,on an empty stomach to detect patients with immune indexes,immunoglobulins(Ig A 、 Ig M 、 Ig E 、 Ig G);stress indicators: 8 a.m.cortisol,8 a.m.ACTH(adrenocorticotropic hormone),c-reactive protein(CRP),white blood cell(WBC);nutritional indicators(albumin,prealbumin).The two groups of clinical data collected were analyzed by SPSS 24.0 statistical software.Results: A total of 61 patients were enrolled in the study,including 30 local analgesic groups and 31 basic analgesic groups.Local analgesia group of patients with postoperative1,2,3,and 4 days of pain score was lower than that in group based analgesia(p < 0.050),the fatigue degree also significantly lower than the base analgesia group(p < 0.050).In comparison with the basal analgesic group,the adrenocorcocorticoid level of the 1st day postoperative corticotropin level and the third day postoperative cortisol level was low,and the difference was statistically significant(p < 0.050).Local analgesic group first exhaust time and first feeding time were earlier than the basic analgesia group(p < 0.050).There was no significant difference in the incidence of postoperative complications between the two groups(p >0.050).Conclusions: By analyzing the clinical research can draw the following conclusion,For laparoscopic colorectal cancer surgery patients,continuous infiltration of incision block can not only obtain good analgesia effect,patients with postoperative fatigue eased,can make patients early ambulation,promote gastrointestinal peristalsis,can recover as soon as possible through the mouth to eat.At the same time,it also enables patients to have normal breathing and expectoration after surgery,which reduces the risk of pneumonia,increases the oxygen utilization rate of the body,and plays a positive role in promoting the healing of intestinal anastomosis and incision.In addition,patients with better analgesic management reduced the number and dosage of systemic drugs,reduced the adverse reactions of systemic drugs,and promoted short-term recovery of patients.In this study,we found that the continuous use of the incision did not increase the risk of postoperative complications.